Provider Demographics
NPI:1568591410
Name:NEW CITY CHIROPRACTIC CENTER LLP
Entity Type:Organization
Organization Name:NEW CITY CHIROPRACTIC CENTER LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:COCILOVO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:845-634-8877
Mailing Address - Street 1:490 ROUTE 304
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-3040
Mailing Address - Country:US
Mailing Address - Phone:845-634-8877
Mailing Address - Fax:845-634-0783
Practice Address - Street 1:490 ROUTE 304
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-3040
Practice Address - Country:US
Practice Address - Phone:845-634-8877
Practice Address - Fax:845-634-0783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2014-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004589111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYXBWDR1Medicare PIN